Arrests, VT and VF

Question 1

Write out the protocol for cardiac arrest?

Answer 1

2222

Start CPR straight away

Assess the rhythm, is it shockable?
If shockable (pulseless VT, VF)
Give shock

Continue cycle: re-asses, shock

During CPR:

• oxygen
• consider secure airway
• Get IV access
• IV adrenaline 1:10,000 1mg every 3-5 mins
• Treat reversible causes

Question 2

When can you give continuous CPR and breaths?

Answer 2

When airway secured

Question 3

What are the reversible causes of cardiac arrest?

Answer 3

Hypothermia
Hypoxia
Hypoglycaemia, hyper/hypokalaemia
Hypovolaemia

Tension pneumothorax
Thrombosis
Toxins
Tamponade

Question 4

Which rhythms are shockable?

Answer 4

Pulseless VT

VF

Question 5

Pulseless electrical activity, is it shockable or not?

Answer 5

No

Question 6

What does PEA look like?

Answer 6

Can look like any electrical rhythm but they have no pulse!

Question 7

Management of PEA or asystole?

Answer 7

2222

Start CPR immediately and continue without interruptions

Continue to assess rhythm to see if it becomes shockable

Oxygen
Secure airway
IV adrenaline 1:10,000 1mg every 3-5 mins

Treat any reversible causes

Question 8

Management of VT with a pulse?

Answer 8

Get help!

Get cardiac monitoring on and a defibrillator nearby

Are they unstable? (BP<90, HR<150, chest pain)

If unstable: sedate and cardioversion, amiodarone after

If stable: Amiodarone 300mg IV over 15 mins
Then 900mg over 24 hours
Cardioversion if required later

Correct any electrolyte imbalances